petdiabetesfandomcom-20200216-history
Case:Maja
Posted by: Maja (IP Logged) Date: November 9, 2005 08:25PM Diagnosis: February 2005 Current insulin: Levemir 0.5 U BID started Nov 30 2005 Previous insulin: Lantus 0.5 U in the AM, 0.5 or 0.25 U in the PM. Nov 3 2005 - Nov 29 2005 Oral treatment: Glipizide February 2005 - November 2005 Maja is a 10-year old Norwegian Forest Cat that was diagnosed with diabetes in February 2005 after having received prednisolone for exczema. She seems to be allergic to fish, and in order to clear up her rash quicker (she had scratched herself bloody), the vet put her on 5 mg prednisolone daily. Together with elimination of all fish-containing food from her diet, Maja's skin healed, but she started to eat, drink and pee excessively. With 2 human diabetics in the family, we suspected diabetes or maybe thyroid disease and called a vet. To our surprise and horror, the vet said she suspected a tumor rather than diabetes (that without having drawn blood from Maja) because Maja's belly was supposedly distended. She referred Maja to an animal clinic for X-rays and further examination. It was Friday, so we called and booked an appointment for Monday morning. At the animal clinic, the vet there did not find Maja's belly distended, nor did she find any indications of a tumor. Maja could go home again, and the clinic called in the afternoon to tell that Maja's BG was high and she had diabetes. We were so relieved that it was "just diabetes" and not a tumor. The vet said that she should try Glipizide and low-carb diet, and that home-testing was very difficult. Nov 3, 2005 After inadequate results with Glipizide (as well as elevated liver enzymes from Glipizide) and low-carb diet, Maja started Lantus today. If we'd known better back then, we'd have skipped the Glipizide and tried insulin instead. The vet we'd talked to was a bit negative about insulin and said Maja'd have to be hospitalized for at least a week until they had her adjusted, and that it was very different from human diabetes, so we couldn't just apply our knowledge about human diabetes on Maja. Then Maja got a new and much better vet at the same clinic. While the new vet doesn't have any experience with Lantus or Levemir (most cats here get Caninsulin/Vetsulin), she was interested in reading the papers we gave her, as well as encouraging about home testing. She also said it wasn't necessary with a week's hospitalization; since we already were familiar with diabetes and had all "equipment" at home already, it'd be less stressful for Maja if we started the insulin at home, monitored Maja closely and kept in touch through phone. However, the vet wasn't keen on prescribing Lantus since she wasn't familiar with it, just Vetsulin, so Maja gets her Lantus from my diabetic sister, which the vet was OK with. My sister is going to switch to Levemir in a while, and if we can't get Lantus from the vets then either, Maja will have to switch to Levemir too. The first days we had 0.5 U Lantus SID, and then 0.5 U BID. Nov 7 Maja's nadir BG was 149, and after a few days, her nadir was down to around 90. Before Lantus, her BG would vary from 250 to 400's. Maja's neuropathy seems to have resolved considerately, and she's even stood on her hindlegs again. She also enjoys chasing the other two cats and jumping over them in order to scare them. When her BG drops quickly, she often gets very lively and runs up and down the stairs, so we usually spot-check her then to make sure her BG hasn't dropped too low. She's very patient and doesn't mind ear-pricking or insulin injections at all. Only downside is that Maja is thin - just 3.8 kg/~8 lbs and doesn't have much fat to pinch, which makes administering insulin difficult. She's gained some weight since her BG got under control, though, and hopefully she'll gain some more. Dec 1, 2005 Maja started Levemir yesterday at 0.5 U BID. According to my sister's endocrinologist, Levemir is slightly weaker than Lantus, and usually gives a more even blood glucose curve - in humans at least. Lantus worked very well for Maja with the exception that 0.5 U would drop her BG 180 mg/dL(10 mmol/L) in 3-4 hours regardless of her preshot BG. Then her BG would stay relatively flat for a couple of hours and go up at around +10-11 hours. Because of this, we had to tinker a lot with Majas insulin dosing, which is difficult since we only have syringes with 1-unit steps. Hopefully Levemir will give Maja a more gentle drop and a flatter glucose curve. Spotchecks today look promising so far. Category:Lantus casesCategory:Oral med casesCategory:Caninsulin casesCategory:Neuropathy casesCategory:Levemir cases